The human microbiome is a wild and wonderful thing. Billions of bacteria live in, on, and around us all, influencing our health in every way. Now, scientists are looking at whether fecal transplants—literally inserting another person's poop into a patient's gastrointestinal tract, via a colonoscopy or enema—could be a powerful way to manipulate the microbiome, and even to cure disease. Poop is a bacteria bomb, and this is a potentially powerful way to deliver a dose to the system.
Fecal transplants have already shown great promise in treating C. difficile infection. A clinical trial is starting up in Hamilton, Ontario in which scientists will test if fecal transplant could help kids with inflammatory bowel disease (IBD), a painful lifelong condition includes both Crohn's disease and ulcerative colitis. It will be the first randomized controlled clinical trial of fecal transplant in kids with IBD done anywhere in the world, according to the researchers.
Patients and their families will probably say, it's about time. There are drugs to treat IBD, but they can come with lasting side effects. When I spoke to this study's principal investigator, Dr. Nikhil Pai of McMaster University, he told me that desperate people are trying DIY fecal transplants at home—even for their kids.
"Parents seem to feel that as long as they're the donor, it'll be safer," he said. "It doesn't work that way." Transplanting your poop into another person can be risky (not to mention messy) business, and in this trial all the stool that will be used comes from anonymous donors. It's pre-screened for disease, and is FDA and Health Canada-approved, he said.
There's good reason to be hopeful that a treatment like this could help. A 2015 study, also done at McMaster, suggested fecal transplant could ease symptoms of adult IBD patients.
"A patient who has Crohn's or ulcerative colitis has a fundamentally different bacterial signature than someone who's healthy," Pai told me. Genetics seem to play a role, but they can't explain the whole picture of the disease. "When you take [identical] twins, there is still only about a 25 percent concordance between them of getting ulcerative colitis," he said.
In this trial, Pai and his team hope to recruit 50 kids, ages six to 17. These kids will either receive a placebo (saline), or an anonymous fecal sample, twice a week for six weeks. (That's twelve enemas, which Pai emphasized just take "five minutes" to do.)
Although a lot more research is needed, fecal transplants are starting to look like they could benefit patients with a variety of conditions, including C. diff and maybe IBD. One day, we might not need donor poop at all. Elsewhere, scientists are making "poop pills" that can be taken by mouth, and a Canadian team has designed an experimental synthetic version (with the wonderful name "RePOOPulate"). Something like that could become the standard of care in the future.
Get six of our favorite Motherboard stories every day by signing up for our newsletter.